胃肠道外科手术中手术部位感染的预后模型:系统性审查
Kenneth A McLean1, Tanvi Goel2, Samuel Lawday3
1Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
The British journal of surgery
|July 11, 2023
概括
现有的风险预测工具在胃肠道手术中无法充分识别手术部位感染 (SSI) 风险. 需要新的工具来改善患者的治疗结果,并有效地针对干预措施.
科学领域:
- 手术成果研究的研究结果.
- 医疗信息学医学信息学
- 流行病学 流行病学
背景情况:
- 手术部位感染 (SSI) 是胃肠道手术后发病的一个重要原因.
- 准确的风险预测对于有针对性的干预和改善患者监测至关重要.
- 胃肠道外科手术中SSI的现有预后工具需要评估.
研究的目的:
- 系统地识别和评估用于预测胃肠道手术后30天SSI的预后工具.
- 评估这些预后模型的开发和验证.
主要方法:
- 对2000年1月至2022年2月发表的研究进行系统审查.
- 在 MEDLINE,Embase,全球健康和 IEEE Xplore 中进行了搜索.
- 排除了具有术后参数或程序特定重点的模型;执行了叙事合成.
主要成果:
- 确定了23种预后模型,57%缺乏内部验证,只有17%接受了外部验证.
- 操作污染和持续时间是常见的预测因素,但存在异质性.
- 大多数模型都有高偏差风险,适用性低,对校准和预后准确性的评估不频繁.
结论:
- 目前的风险预测工具不足以用于胃肠道外科手术的常规使用.
- 现有的模型显示差别和准确性很差,即使在外部验证后.
- 开发新的风险分层工具对于有效的术后管理至关重要.
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